STEMI
Conditions
Brief summary
The target population of this interventional study was STEMI patients. Primary discussion: Early rhBNP reduces microcirculation obstruction in STEMI patients undergoing primary PCI
Detailed description
Direct percutaneous coronary intervention is the preferred reperfusion strategy for acute ST-segment elevation myocardial infarction. During the opening of infarct-related vessels, 5%-50% of patients showed slow flow or no reflow and other coronary microcirculation dysfunction, which aggravated myocardial injury and increased the incidence and mortality of heart failure. Studies have shown that recombinant human brain natriuretic peptide (rhBNP) can reduce reperfusion injury and reduce myocardial infarction area CMD. Prolonged ischemia leads to rapid depletion of intracellular ATP and tissue metabolic acidosis. Blood flow irrigation during reperfusion leads to decreased levels of ATP precursors, calcium overload in mitochondria, release of a large number of inflammatory factors and oxygen free radicals, which can lead to injury or death of myocardial and endothelial cells. rhBNP can enhance the activity of antioxidant enzymes, reduce the irreversible oxidative damage caused by free radicals to myocardium, reduce the myocardial infarction area during ischemia reperfusion, and may reduce the reperfusion injury and protect the viable myocardium.
Interventions
DRUGrecombinant human B-type natriuretic peptide
The recombinant human B-type natriuretic peptide produces physiological effects by imitating endogenous B-type natriuretic peptide
Sponsors
Henan Institute of Cardiovascular Epidemiology
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* STEMI * PPCI within 24 hours of symptom onset * Target vessel QFR-MR\>250mm Hg\*s/m
Exclusion criteria
* claustrophobia * Postoperative TIMI grade 0-1 * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| MVO/LV(%) | 3-14 days after PPCI | Microvascular obstruction assessed by magnetic resonance imaging |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| IMH | 3-14 days after PPCI | Intramuscular hemorrhageCardiac assessed by magnetic resonance imaging |
| MVO/LV(%) | 30±7 days after PPCI | Microvascular obstruction assessed by magnetic resonance imaging |
| LVEDV(ml) | 3-14 days and 90±7 days after PPCI | Assessed by magnetic resonance imaging |
| LGE/LV(%) | 3-14 days and 90±7 days after PPCI | Cardiac magnetic resonance imaging |
| Troponin (highest value) | 3-14 days after PPCI | Troponin (highest value) |
| MACCEs | 7days，30days，3months，6 months | Major Adverse Cardiac and Cerebrovascular event：Death, nonfatal myocardial infarction, heart failure, revascularization, stroke |
| LVESV(ml) | 3-14 days and 90±7 days after PPCI | Assessed by magnetic resonance imaging |
Contacts
Primary ContactQuan Guo
Outcome results
None listed